Is this reasonable or just over the top?

  1. Recently our Nurse Manager informed the nursing staff that we were now to conduct our shift report using certain "scripted" parameters. Basically, we are to wake patients up, conduct shift report at the bedside, include he patient in the process by giving him/her the opportunity to ask questions and add to the information we pass on to the oncoming shift, check all patient orders on the computer and then conduct a brief"physical exam" of the patient with the oncoming nurse. There are certain scripted things we are to say as well. For example the nurse going off shift is supposed to say:

    "Good morning, Mr. Jones. I will be leaving shortly to go home to my family. This is Sally and she will be your nurse for the next shift. I have known Sally for 4 years and she is a fabulous nurse with excellent clinical skills. I feel confident I will be leaving you in good hands wth Sally as your nurse!"

    After this, we are to continue on with the above outlined report, conduct the mini physical exam, check the orders in the computer and give the patient the opportunity to give feedback during our report. Generally we each have 5-6 patients on our very busy cardiac monitoring unit and our shift report is 30 minutes long!! My colleagues and I are at a loss to figure out how we will accomplish all of this in 30 minutes! I am all for including the patient and allowing them to give feedback, but I fear shift report will now take so long we won't be able to get all our work done! And what about visiting hours? Shift report takes place right in the middle of them at 7pm. Now there will be visitors for both patients adding their comments as well.

    In addition, I am uncomfortable giving my opinion about the skills and expertise of the oncoming nursing staff. We are expected to stick to the script and give positive reinforcement about the capabilities of the next nurse coming on shift. What if he/she isn't a very good nurse or has poor clinical skills? Am I supposed to lie to the patient? And if I do, won't I be undermining my own credibility? Does anyone else think this is a little over the top?
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  2. 127 Comments

  3. by   AJJKRN
    Welcome to the customer service model and bedside report. These hoops are the bane of my existence as a hospital nurse. Just wait til the patient white boards show up.

    Strategy 3: Nurse Bedside Shift Report | Agency for Healthcare Research & Quality

    Healthcare leader and staff tools | Studer Group
  4. by   SaltineQueen
    Things like this make me glad I'm not in a hospital setting any more.
  5. by   Jolie
    Based upon my recent experiences with 3 family members who had stays on various nursing units of 5 different hospitals, I greatly appreciated a brief introduction of the on-coming nurse by the off-going nurse. For some of my family members, a bedside report including the patient and family was appropriate and welcomed. For others, it was the wrong thing to do, but happened anyway, because that was the protocol.

    As a nurse, a manager, a business owner and a family member, I have little respect or patience for mandates that require a one-size-fits-no-one approach to any aspect of healthcare, or any other service.

    If administration can't trust their highly educated and licensed professional care givers to effectively share necessary information, they need to re-evaluate their hiring and training process, not write stupid scripts.

    I'm not a robot or an actress. I don't deliver made-up lines to an audience. If I was handed that script, my interpretation of it would be something like this," It's time for me to leave to meet my co-workers at Joe's Bar & Grill where we will tell jokes at our boss's expense until they turn out the lights and kick us out. Hopefully someone will be sober enough to drive home by then."

    I was once floated from the NICU to Oncology. I was asked to explain my cutesy, baby-themed scrubs to patients and families by mumbling some BS about "teamwork and information sharing." Nothing doing. I told the truth. Funny, I was never again asked to leave my home department.
  6. by   brownbook
    Honest to God, you are supposed to, wake the patient up?
  7. by   KatieMI
    IMHO, it is WAY over the top. Starting with waking the patient up, and with everything that follows.

    The good news: if everybody (and I mean that:every single nurse in the unit) will either 1) clock off late because of meticulously following that schmolicy AND write down an explanatory note every single time it happens, as well as every single time when patient refuses to participate in that circus; 2) file incident report and write down a full blown note about every single patient/family member unhappy with being woken up (I assure you, there will be plenty of them), and/or 3) tell the aforementioned unhappy "customers" something like that: "I am sorry to see you not happy about me waking up your mom but I am just doing my job and I can be fired if I omit any part of it; here are paper and pen, please write down a letter to management team, and also please make sure that you mention this in the survey you'll fill at the time of your mother' discharge", then the whole madness will die within weeks.

    Or, if you can afford it otherwise, just vote with your feet and take medical/family/vacation leave for the remaining two weeks
  8. by   meanmaryjean
    I wonder what suit thought this up?
  9. by   caliotter3
    I can see the routine, however, the scripting is too much.
  10. by   Ruas61
    Yee gads......................
  11. by   tyvin
    No way....over the top...nursing has turned into an unrecognizeable bureaucratic mess... By nature patients are often complaint magnets and people just like to gossip. I can see the writng on the wall. If the family is in the room; good luck getting out of there. Sounds like something the social worker needs to do.

    I'm not going into a patient's room and say how I know the oncoming nurse or whether I'm going home to my family or out to a bar and down 6 shots of Jack because that's how I descalate from a work shift. It's none of their business. Facilites are places of business, not social functions to all hold hands and sing Kumbaya.

    Next, there will be safe places for patients who get tramatized due to the change of shift.

    Talk about a waste of time...IMO of course. I can't even pee half the time or eat lunch let alone walk into every patient's room with the oncoming staff and have a chit chat about where I'm going after work and how I trust incoming.
  12. by   Luckyyou
    Wonder how they would feel if I told the truth, instead of "I'm going home to be with my family, your day nurse sure is super fabulous!": "Mr Smith, sorry for waking you after you finally managed to fall asleep at 6AM. I'm going home to eat a Lean Cuisine in front of the TV with my three cats and try to forget the fact that if I was killed by falling down the stairs at home, no one would notice unless I failed to show up for work, but by that time, said cats would have already chewed my dead face off. This is your day shift nurse... um, whatever her name is. Probably Katie or Abby, most of our 40 new nurses are one of the two. I'm sure she'll take great care of you, especially since management just sent out that super helpful email reminding people that the proper procedure to take off a stuck microclave from a PICC doesn't involve cutting it off with a pair of scissors. Anyway, she's been a nurse for like six months but she's already in FNP school, so I'm sure it'll be fine. Bye!"

    So glad my patients don't talk.
  13. by   BSNbeDONE
    We had to do this a few years back. One of the patients blew a gasket after being hospitalized for a few days and hearing the same thing over and over and over....his response? "Why the h*** do you people act like d*** robots? I'm an individual; talk to me based on me! Get the h*** outta my room"!

    Of course the manager that would stand outside the door eavesdropping with the script and clipboard to make sure we were "following the protocol", went scrambling back up the hall when she heard the patient's reaction. So much for treating the 'individual' patient.
  14. by   SmilingBluEyes
    Who came up with this lunacy? Studer and their ilk. See, patients are NOT stupid. They pick up on these silly lines and tactics and I have seen people here tell of them asking "what are you robots or Stepford Nurses-----why do you all say the same silly things"? or something similar. This makes them uncomfortable and insults their intelligence. I just feel lucky that none of the hospital systems in which I worked had this in place because there is no way I could have been able to do it. It demeans us and our patients, all in one stupid silly one-liner.

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